title: Urban leptospirosis in Africa: a cross-sectional survey of Leptospira infection in rodents in the Kibera urban settlement, Nairobi, Kenya.
abstract: Leptospirosis is a widespread but under-reported cause of morbidity and mortality. Global re-emergence of leptospirosis has been associated with the growth of informal urban settlements in which rodents are thought to be important reservoir hosts. Understanding the multi-host epidemiology of leptospirosis is essential to control and prevent disease. A cross-sectional survey of rodents in the Kibera settlement in Nairobi, Kenya was conducted in September-October 2008 to demonstrate the presence of pathogenic leptospires. A real-time quantitative polymerase chain reaction showed that 41 (18.3%) of 224 rodents carried pathogenic leptospires in their kidneys, and sequence data identified Leptospira interrogans and L. kirschneri in this population. Rodents of the genus Mus (37 of 185) were significantly more likely to be positive than those of the genus Rattus (4 of 39; odds ratio = 15.03). Questionnaire data showed frequent contact between humans and rodents in Kibera. This study emphasizes the need to quantify the public health impacts of this neglected disease at this and other urban sites in Africa.
authors.forename: Jo E B
authors.initials: JEB
authors.lastname: Halliday
authors.forename: Darryn L
authors.initials: DL
authors.lastname: Knobel
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Allan
authors.forename: B Mark
authors.initials: BM
authors.lastname: de C Bronsvoort
authors.forename: Ian
authors.initials: I
authors.lastname: Handel
authors.forename: Bernard
authors.initials: B
authors.lastname: Agwanda
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Cutler
authors.forename: Beatrice
authors.initials: B
authors.lastname: Olack
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ahmed
authors.forename: Rudy A
authors.initials: RA
authors.lastname: Hartskeerl
authors.forename: M Kariuki
authors.initials: MK
authors.lastname: Njenga
authors.forename: Sarah
authors.initials: S
authors.lastname: Cleaveland
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
mesh_terms: D000818:Animals; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000235:genetics; D004197:Disease Reservoirs; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D007919:Leptospira / Q000235:genetics / Q000302:isolation & purification; D007921:Leptospira interrogans / Q000235:genetics / Q000302:isolation & purification*; D007922:Leptospirosis / Q000453:epidemiology / Q000382:microbiology / Q000662:veterinary*; D008297:Male; D051379:Mice; D015999:Multivariate Analysis; D010802:Phylogeny; D051381:Rats; D060888:Real-Time Polymerase Chain Reaction; D012376:Rodent Diseases / Q000453:epidemiology* / Q000382:microbiology; D012377:Rodentia; D011795:Surveys and Questionnaires; D014504:Urban Health
chemical_list: D004269:DNA, Bacterial